Ischemic heart disease and cardiomyopathy in pregnancy

Ischemic heart disease and cardiomyopathy in pregnancy are both rare. Therefore, a high level of suspicion is required by the obstetric caregiver when women complain of the often vague symptoms that are indicative of these conditions. Early diagnosis, consultation with a cardiologist, and aggressive therapy are the keys to reducing morbidity and mortality. Women who suffer myocardial infarction in pregnancy should be stabilized, and delivery within the first two weeks post event should be avoided if possible. Women who completely recover from peripartum cardiomyopathy can be reassured when considering future pregnancies. Pregnancy should be considered contraindicated in women with Class H diabetes, and efforts should be made to establish reliable contraception. This is the fourth in a series of five articles reviewing in detail the assessment and management of specific cardiac disorders in pregnancy.